Cases That Test Your Skills

Sleepless and paranoid

Current Psychiatry. 2013 April;12(4):39-43

References

1. Mai E, Buysse DJ. Insomnia: prevalence impact, pathogenesis, differential diagnosis, and evaluation. Sleep Med Clin. 2008;3(2):167-174.

2. Kennedy N, Boydell J, Kalidindi S, et al. Gender differences in incidence and age at onset of mania and bipolar disorder over a 35-year period in Camberwell, England. Am J Psychiatry. 2005;162(2):257-262.

3. Cook IA. American Psychiatric Association. Guideline watch: practice guidelines for the treatment of patients with delirium. http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1681952. Accessed June 20 2012.

4. Lonergan E, Luxenberg J, Areosa Sastre A, et al. Benzodiazepines for delirium. Cochrane Database Syst Rev. 2009;21(1):CD006379.-

5. Toner LC, Tsambiras BM, Catalano G, et al. Central nervous system side effects associated with zolpidem treatment. Clin Neuropharmacol. 2000;23(1):54-58.

6. Srinivasan V, Pandi-Perumal SR, Trahkt I, et al. Melatonin and melatonergic drugs on sleep: possible mechanisms of action. Int J Neurosci. 2009;119(6):821-846.

7. Al-Aama T, Brymer C, Gutmanis I, et al. Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. Int J Geriatr Psychiatry. 2011;26(7):687-694.

8. Lonergan E, Britton AM, Luxenberg J, et al. Antipsychotics for delirium. Cochrane Database Syst Rev. 2007;18(2):CD005594.-

9. Medori R, Tritschler HJ, LeBlanc A, et al. Fatal familial insomnia, a prion disease with a mutation codon 178 of the prion protein gene. N Engl J Med. 1992;326(7):444-449.

10. Lugaresi E, Provini F, Cortelli P. Agrypnia excitata. Sleep Med. 2011;12(suppl 2):S3-S10.

11. Diagnostic and statistical manual of mental disorders, 4th ed, text rev. Washington DC: American Psychiatric Association; 2000.

12. Jaffe JH, Strain EC. Opioid-related disorders. In: Sadock BJ Sadock VA, eds. Kaplan and Sadock’s comprehensive textbook of psychiatry. 8th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2005:1164, 1272-1274.

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Table 3

DSM-IV-TR diagnostic criteria for opioid withdrawal

A.	Either of the following: Cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer) Administration of an opioid antagonist after a period of opioid use
B.	≥3 of the following, developing within minutes to several days after criterion A: dysphoric mood nausea or vomiting muscle aches lacrimation or rhinorrhea pupillary dilation, piloerection, or sweating diarrhea yawning fever insomnia
C.	The symptoms of criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D.	The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder
Source: Reference 11

Related Resources

Morin CM, Benca R. Chronic insomnia. Lancet. 2012; 379(9821):1129-1141.
Pressman MR, Orr WC, eds. Understanding sleep: the evolution and treatment of sleep disorders. Washington, DC: American Psychological Association; 1997.
NIH State-of-the-Science Conference Statement on manifestations and management of chronic insomnia in adults. NIH Consens State Sci Statements. 2005;22(2):1-30.

Drug Brand Names

Albuterol • Proventil, Ventolin
Aripiprazole • Abilify
Bupropion • Wellbutrin, Zyban
Dextroamphetamine • Dexadrine
Haloperidol • Haldol
Hydrocodone/Acetaminophen • Vicodin
Lamotrigine • Lamictal
Lorazepam • Ativan
Methylphenidate • Methylin, Ritalin
Phenylephrine • Neo-Synephrine
Pseudoephedrine • Sudafed
Ramelteon • Rozerem
Theophylline • Elixophyllin, Slo-Phyllin
Zolpidem • Ambien

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

Sleepless and paranoid

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